The importance of psychosocial factors, gender, and severity of depression in distinguishing between adjustment and depressive disorders.

BACKGROUND: This study evaluated the severity of depressive symptomatology as it relates to: (a) sociodemographic factors and (b) the occurrence and type of acute and chronic psychosocial triggers or life events before admission.
METHODS: In total, 718 psychiatric inpatients were assessed with the AMDP-system by the treating psychiatrist within the first 2 days after admission.
RESULTS: In the females, sociodemographic factors (being married, children in the household, higher education and the quality of interactions) but not psychosocial stressors or life events were found to be related to severity of depression on admission. Females showed more severe depressive syndromes than males, however, depression severity in males was independent of sociodemographic factors, life events or psychosocial triggers. LIMITATIONS: Clinical assessment was based on retrospective history taking. The sample consisted of inpatients only, the results require replication using larger and more diverse samples.
CONCLUSION: Gender differences and life conditions such as familial distress are related to severity of depression. The present criteria for the differentiation between depressive disorders and adjustment disorders are not independent and should be substituted by a multiaxial assessment.